The Experience of Addiction as Told by the Addicted: Incorporating Biological Understandings into Self-Story

Rachel R. Hammer, Molly J. Dingel, Jenny E. Ostergren, Katherine E. Nowakowski, Barbara A. Koenig

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


How do the addicted view addiction against the framework of formal theories that attempt to explain the condition? In this empirical paper, we report on the lived experience of addiction based on 63 semi-structured, open-ended interviews with individuals in treatment for alcohol and nicotine abuse at five sites in Minnesota. Using qualitative analysis, we identified four themes that provide insights into understanding how people who are addicted view their addiction, with particular emphasis on the biological model. More than half of our sample articulated a biological understanding of addiction as a disease. Themes did not cluster by addictive substance used; however, biological understandings of addiction did cluster by treatment center. Biological understandings have the potential to become dominant narratives of addiction in the current era. Though the desire for a "unified theory" of addiction seems curiously seductive to scholars, it lacks utility. Conceptual "disarray" may actually reflect a more accurate representation of the illness as told by those who live with it. For practitioners in the field of addiction, we suggest the practice of narrative medicine with its ethic of negative capability as a useful approach for interpreting and relating to diverse experiences of disease and illness.

Original languageEnglish (US)
Pages (from-to)712-734
Number of pages23
JournalCulture, Medicine and Psychiatry
Issue number4
StatePublished - Dec 2012
Externally publishedYes

Bibliographical note

Funding Information:
Acknowledgments The project described was supported by Grant Number R01 DA014577 from the National Institute on Drug Abuse and the Mayo Clinic SC Johnson Genomics of Addiction Program. The authors wish to thank the following for assistance with recruiting and interaction with participants, interviewing, coding, and analysis: [alphabetical] Kathleen Heaney, Jennifer McCormick, Bradley Partridge, Marguerite Robinson, and Marion Warwick.


  • Addiction
  • Biological etiology
  • Narrative therapy
  • Substance use disorders


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